アハラシアの肺拡張と外科的な筋切除
Steven R Lopushinsky1, David R Urbach
1Department of Surgery, University of Toronto, Toronto, Ontario.
JAMA
|November 9, 2006
まとめ
アカラシアの治療のための肺の膨張は,外科的な筋切除と比較して,その後の介入のリスクが高くなります. この違いは,主に重複的な空気膨張によるものであって,より多くの手術によるものではない.
科学分野:
- 胃腸内科 胃腸内科
- 外科技術革新は,外科技術革新である.
- 医療サービス 研究 医療サービス
背景:
- アハラシアの治療には,通常,肺の膨張や外科的な筋切除が含まれます.
- これらのアハラシア治療を比較する集団ベースのアウトカムデータは限られている.
研究 の 目的:
- アカラシアの初期治療として,肺拡張と外科的筋切除の長期的な結果を比較する.
- 初期アハラシア治療後の後の介入の必要性と医療利用の必要性を評価する.
主な方法:
- オンタリオ州 (1991-2002) の1461人のアハラシア患者 (≥18歳) の遡及的研究.
- 初期の肺の膨張 (80.8%) と外科的な筋切除 (19.2%) を比較した.
- 後の介入,医師の診察,薬物の使用を分析し,混同要因を調整した.
主要な成果:
- 肺拡張 (36.8%, 56.2%, 63.5%) と外科的筋切除 (16.4%, 30.3%, 37.5%) の間で,1,5,10年後の後の介入の累積リスクがより高い.
- 後の介入に対する調整された危険比率は,空気膨張のために2.37 (95%CI,1.86〜3.02) であった.
- 後の手術による筋切除,食道切除,医師の診察,または胃腸内薬の使用において,グループ間の有意な違いはありませんでした.
結論:
- 最初のアハラシア治療の後,その後の介入は一般的です.
- 肺の膨張は,外科的筋組織切除よりも,その後の介入の大きなリスクと関連しています.
- 呼吸器の膨張によるリスクの増加は,主に繰り返された膨張の手続きによるものです.
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